Dawaa Reference

Clinical reference

Intestinal intussusception

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Child Intussusception - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK431078/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD99.02 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Intestinal intussusception - disease-level clinical article (intussusception-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (12)

  • Early presentation is intermittent colicky belly pain, nausea, bile-stained (green) vomiting, and drawing the legs up to the chest [abdominal pain · nausea · vomiting]
  • Pain comes and goes because the affected bowel segment stops contracting between episodes
  • Later in the course, rectal bleeding with red currant jelly stool and lethargy develop [lethargy · rectal bleeding]
  • Children may cry, pull the knees to the chest, or become short of breath during pain spasms [breathlessness · spasm]
  • Fever is not itself a feature but can develop if the bowel becomes ischemic, perforates, and sepsis sets in [fever · ischaemia · sepsis]
  • Rarely, intussusception complicates Henoch-Schonlein purpura, presenting with severe abdominal pain on top of that disease's usual features [abdominal pain · purpura · rash]
  • The abdomen is bloated and distended, alongside the waxing and waning pain, the vomiting and the bloody stool [abdominal distension · vomiting]
  • The usual age is six to 18 months
  • In a child no cause is usually found; in an adult there is usually a lead point, and it is usually a cancer
  • What raises the risk in a child is infection, cystic fibrosis, or an intestinal polyp [polyp]
  • A third of children have had an upper respiratory infection, otitis media or a flu-like illness in the days before it started
  • Bacterial enteritis is associated with it too - Salmonella, Escherichia coli, Shigella and Campylobacter - most often within the month after the infection

Signs — what you find (3)

  • A palpable sausage-shaped abdominal mass is a classic exam finding [abdominal mass]
  • Dance sign - retraction felt in the right lower quadrant - points toward intussusception
  • Digital rectal exam can sometimes feel the leading edge of bowel (the intussusceptum)

Tests (10)

  • Ultrasound is the diagnostic test of choice, confirmed by a target or doughnut sign roughly 3 cm across
  • On cross-section the doughnut shape comes from a bright bowel-and-mesentery core surrounded by a darker swollen outer bowel wall
  • Viewed lengthwise, the intussusception can look like a sandwich
  • Abdominal x-ray can be used to check for bowel obstruction
  • An air enema can both diagnose and, in the same procedure, treat the intussusception
  • CT is used when ultrasound findings are equivocal, though young children often need anesthesia for it along with contrast and radiation exposure
  • It can obstruct the small bowel
  • It can go on to peritonitis or perforation of the bowel
  • Enema reduction succeeds in more than 80% of cases
  • Up to 10% recur within 24 hours of a successful reduction, so the child is not finished with when the enema works

If not this — what else fits (3)

  • Blunt abdominal trauma is also on the differential list in the emergency setting
  • Cyclic vomiting syndrome is named as another differential to consider
  • Gastroenteritis requiring emergent treatment is included among the differentials

SourceStatPearls "Child Intussusception" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Telescoping of one bowel segment into an adjacent one, causing intermittent colicky abdominal pain, vomiting, and 'currant jelly' stools, most often in infants and toddlers. This is a surgical emergency needing immediate hospital transfer for radiologic (air/contrast enema) or surgical reduction; GP's role is recognition, analgesia if needed, and urgent same-day referral. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Telescoping of one bowel segment into an adjacent one, causing intermittent colicky abdominal pain, vomiting, and 'currant jelly' stools, most often in infants and toddlers. This is a surgical emergency needing immediate hospital transfer for radiologic (air/contrast enema) or surgical reduction; GP's role is recognition, analgesia if needed, and urgent same-day referral.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Fever indicates bowel necrosis, perforation, and sepsis secondary to bowel ischemia.
  • RED FLAG - Up to 10% of intussusception cases may recur within 24 hours after reduction.
  • RED FLAG - Blood or mucus per rectum ('currant jelly' stool), a palpable sausage-shaped abdominal mass, lethargy or altered consciousness, or signs of peritonitis or bowel ischemia.

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